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. 2025 Jul 18.
doi: 10.1097/ACO.0000000000001552. Online ahead of print.

Enhanced recovery after surgery in ambulatory procedures

Juan P Cata  1   2 , Daniel S Cukierman  3 , Silvia Natoli  4   5
Affiliations

Enhanced recovery after surgery in ambulatory procedures

Juan P Cata et al. Curr Opin Anaesthesiol. .

Abstract

Purpose of review: The expansion of ambulatory surgeries has increased the demand for efficient, safe, and patient-centered perioperative strategies. Enhanced recovery after surgery principles offer a structured framework to streamline ambulatory care. This review highlights recent evidence and advancements in the management of patients undergoing ambulatory procedures.

Recent findings: Recent evidence has broadened the anesthetic armamentarium for ambulatory enhanced recovery pathways. Hypnotics such as remimazolam and ciprofol show promising safety profiles in select patient populations. Adjunct anesthetics, including low-dose ketamine, low-dose dexmedetomidine, and methadone, are increasingly being studied for opioid sparing analgesia. Other advances include Bispectral index-guided closed-loop systems, refined antiemetic strategies, and patient-centered recovery metrics to guide discharge readiness.

Summary: Current evidence endorses the utilization of enhanced recovery protocols for ambulatory anesthesia, with anesthesiologists assuming a pivotal role. Additional research is required to assess newer agents within these enhanced recovery frameworks, establish standardized patient-centered outcome measures, and incorporate real-time audit tools.

Keywords: ambulatory surgical procedures; enhanced recovery protocols; intravenous anesthesia; multimodal analgesia; postoperative nausea and vomiting.

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